DOI: 10.36347/sjmcr.2015.v03i12.026

Pages: 1222-1225

Corneal opacities at birth present a challenging scenario to the treating physician in terms of diagnosis and management. A week-old term child delivered via unassisted vaginal delivery was referred for bilateral corneal opacities that were noted since birth. Examination under anaesthesia revealed anterior staphyloma of the corneas with normal intraocular pressures. Ultrasound biomicroscopy revealed kerato iridolenticular adhesion with mal development of the lens, while B-scan showed a flat retina and clear vitreous. Systemically, there were no other congenital abnormalities detected. A diagnosis of bilateral keratoirido lenticular dysgenesis with anterior staphyloma was made. Initial treatment was mainly topical lubricants, but medial tarsorrhaphy was performed on both eyes due to corneal thinning secondary to exposure keratopathy. After counselling her parents, the child underwent right eye penetrating keratoplasty at 6 months old. Although initially showing slight improvement in vision and also better cosmesis, the corneal graft eventually became fully vascularized again after one year post-operatively. It is therefore imperative that parents of children with this condition be counseled thoroughly and their expectations be handled delicately to ensure the best possible outcome.